A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?

Observe for signs of infection

Examine the skin for generalized urticaria

Review laboratory test results for low hemoglobin

Monitor the mouth for signs of xerostomia

Answer and Explanation

The Correct Answer is A

Radiation therapy can cause immunosuppression, which increases the risk of infection. The nurse should monitor the client for signs of infection such as fever, chills, malaise, or purulent drainage.

Examine the skin for generalized urticaria. This is not a common side eﬀect of radiation therapy, as urticaria is an allergic reaction that causes hives or welts on the skin. Radiation therapy can cause localized skin irritation, erythema, or dryness, but not generalized urticaria.
Review laboratory test results for low hemoglobin. This is not a direct eﬀect of radiation therapy, as hemoglobin is a component of red blood cells that carries oxygen in the blood. Radiation therapy can cause anemia, which is a low number of red blood cells, but not necessarily low hemoglobin.
Monitor the mouth for signs of xerostomia. This is not relevant for a client who receives radiation therapy to treat lung cancer, as xerostomia is dry mouth caused by reduced salivary gland function. This can occur in clients who receive radiation therapy to treat head and neck cancer, but not lung cancer.

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Correct Answer is ["A","D"]

Explanation

Answer: A, D

Rationale:

A. The medication will prevent wheezing: Albuterol is a bronchodilator, specifically a beta-2 agonist, that relaxes smooth muscles in the airways. This action helps prevent wheezing by reducing airway constriction, making breathing easier for the client.
B. The medication will decrease coughing episodes: While albuterol can help reduce cough indirectly by improving airflow and decreasing airway irritation, it is not primarily used to decrease coughing episodes. Other medications, such as corticosteroids, are often more effective for controlling chronic cough related to inflammation.
C. The medication will reduce inflammation: Albuterol does not have anti-inflammatory properties. Its primary mechanism is bronchodilation, and anti-inflammatory treatment generally requires corticosteroids, not beta-agonists like albuterol.
D. The medication will open the airways: Albuterol works by relaxing bronchial muscles, leading to bronchodilation and allowing the airways to open. This reduces shortness of breath and improves airflow, a primary reason for its use in conditions like asthma.
E. The medication will stimulate flow of mucus: Albuterol does not stimulate mucus production; it primarily works by relaxing the airways. However, by improving airflow, it can help clients more effectively expel mucus through coughing.

A. Administer low-ﬂow oxygen continuously via nasal cannula. B. Oﬀer high-protein and high-carbohydrate foods frequently. C. Place in a prone position. D. Encourage oral intake of at least 3,000 mL of ﬂuids per day.

Correct Answer is C

Explanation

Placing the client in a prone position improves oxygenation and ventilation by reducing lung compression, increasing lung expansion, and redistributing blood ﬂow to better match ventilation.

a) Administering low-ﬂow oxygen via nasal cannula is not sufficient for a client with ARDS, who requires
high levels of oxygenation and positive pressure ventilation to prevent alveolar collapse and hypoxemia.
b) Oﬀering high-protein and high-carbohydrate foods frequently is beneficial for a client with ARDS, as it provides adequate nutrition and energy to support lung healing and prevent muscle wasting. However, it is not the priority intervention for improving respiratory function.
d) Encouraging oral intake of at least 3,000 mL of ﬂuids per day is contraindicated for a client with ARDS, who is at risk of ﬂuid overload and pulmonary edema. Fluid intake should be restricted and diuretics should be administered as prescribed to reduce ﬂuid accumulation in the lungs.

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A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

A nurse is planning care for a client who has acute respiratory distress syndrome (ARDS). Which of the following interventions should the nurse include in the plan?

Correct Answer is C

Explanation

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